1
|
Nguyen KH, Chung EL, McChesney C, Vasudevan L, Allen JD, Bednarczyk RA. Changes in general and COVID-19 vaccine hesitancy among U.S. adults from 2021 to 2022. Ann Med 2024; 56:2357230. [PMID: 38813804 PMCID: PMC11141308 DOI: 10.1080/07853890.2024.2357230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 04/26/2024] [Indexed: 05/31/2024] Open
Abstract
INTRODUCTION Understanding changes in vaccine hesitancy, overall and by sociodemographic characteristics, may highlight sub-populations for whom more intensive efforts are needed to increase vaccine uptake and confidence. METHODS We analyzed data using the CDC's Research and Development Survey (RANDS), a nationally representative survey of U.S. adults ≥18 years, collected from 17 May 2021-30 June 2021 (n = 5,458) and 3 November 2022-12 December 2022 (n = 6,821). We assessed changes in vaccine hesitancy, changes in vaccine attitudes and attitudes, and factors associated with hesitancy toward both vaccines in general and COVID-19 vaccines among a nationally representative sample of U.S. adults. RESULTS Although COVID-19 vaccination (≥1 dose) increased from 67.2% (2021) to 74.7% (2022), COVID-19 vaccine hesitancy increased from 40.7% to 44.6% during the same period. During the same period, hesitancy toward both COVID-19 vaccines and vaccines in general increased among those who were aged ≥65 years and who were non-Hispanic White. However, COVID-19 vaccine hesitancy decreased among non-Hispanic Black adults. Current or former smokers were more hesitant toward vaccines in general (aPR = 1.13, 95%CI: 1.03-1.24) and toward COVID-19 vaccines (aPR = 1.08, 95%CI: 1.01-1.16) compared to never smokers. Among adults who did not receive any COVID-19 vaccines, COVID-19 vaccine hesitancy increased from 86.6% in 2021 to 92.4% in 2022. Furthermore, belief in the overall social benefit of the COVID-19 vaccine decreased from 47.5% to 25.1%. CONCLUSION This study highlights concerning trends in vaccine hesitancy and uptake of the COVID-19 and other recommended vaccines. We found that some high-risk groups (e.g. smokers) and population subgroups have become more vaccine hesitant, suggesting the need for improved and intensified strategies to increase vaccine confidence and uptake. Future research may focus on qualitative inquiry to understand specific concerns and determinants contributing to increased hesitancy among these groups to help inform interventions and communication campaigns to support vaccination.
Collapse
Affiliation(s)
- Kimberly H. Nguyen
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - E. Lisa Chung
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Cheyenne McChesney
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Lavanya Vasudevan
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | | | - Robert A. Bednarczyk
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
- Emory Vaccine Center, Emory University, Atlanta, GA, USA
| |
Collapse
|
2
|
Olusanya OA, Masters NB, Zhang F, Sugerman DE, Carter RJ, Weiss D, Singleton JA. Sociodemographic Trends and Correlation between Parental Hesitancy towards Pediatric COVID-19 Vaccines and Routine Childhood Immunizations in the United States: 2021-2022 National Immunization Survey-Child COVID Module. Vaccines (Basel) 2024; 12:495. [PMID: 38793746 PMCID: PMC11126092 DOI: 10.3390/vaccines12050495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 04/24/2024] [Accepted: 04/24/2024] [Indexed: 05/26/2024] Open
Abstract
Multiple factors may influence parental vaccine hesitancy towards pediatric COVID-19 vaccines and routine childhood immunizations (RCIs). Using the United States National Immunization Survey-Child COVID Module data collected from parents/guardians of children aged 5-11 years, this cross-sectional study (1) identified the trends and prevalence estimates of parental hesitancy towards pediatric COVID-19 vaccines and RCIs, (2) examined the relationship between hesitancy towards pediatric COVID-19 vaccines and RCIs, and (3) assessed trends in parental hesitancy towards RCIs by sociodemographic characteristics and behavioral and social drivers of COVID-19 vaccination. From November 2021 to July 2022, 54,329 parents or guardians were interviewed. During this 9-month period, the proportion of parents hesitant about pediatric COVID-19 vaccines increased by 15.8 percentage points (24.8% to 40.6%). Additionally, the proportion of parents who reported RCIs hesitancy increased by 4.7 percentage points from November 2021 to May 2022 but returned to baseline by July 2022. Over nine months, parents' concerns about pediatric COVID-19 infections declined; however, parents were increasingly worried about pediatric COVID-19 vaccine safety and overall importance. Furthermore, pediatric COVID-19 vaccine hesitancy was more prevalent among parents of children who were White (43.2%) versus Black (29.3%) or Hispanic (26.9%) and those residing in rural (51.3%) compared to urban (28.9%) areas. In contrast, RCIs hesitancy was higher among parents of children who were Black (32.0%) versus Hispanic (24.5%) or White (23.6%). Pediatric COVID-19 vaccine hesitancy was 2-6 times as prevalent among parents who were RCIs hesitant compared to those who were RCIs non-hesitant. This positive correlation between parental hesitancy towards pediatric COVID-19 vaccines and RCIs was observed for all demographic and psychosocial factors for unadjusted and adjusted prevalence ratios. Parent-provider interactions should increase vaccine confidence, shape social norms, and facilitate behavior change to promote pediatric vaccination rates.
Collapse
Affiliation(s)
- Olufunto A. Olusanya
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30333, USA
- Center for Biomedical Informatics, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN 38103, USA
| | - Nina B. Masters
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30333, USA
- Epidemic Intelligence Service, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30333, USA
| | - Fan Zhang
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30333, USA (J.A.S.)
| | - David E. Sugerman
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30333, USA
| | - Rosalind J. Carter
- Office of the Director, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30333, USA
| | - Debora Weiss
- Division of Global HIV and TB, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30333, USA
| | - James A. Singleton
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30333, USA (J.A.S.)
| |
Collapse
|
3
|
Rand CM, Stephens-Shields AJ, Kelly MK, Localio R, Hannan C, Grundmeier RW, Shone LP, Steffes J, Davis K, Albertin C, Humiston SG, McFarland G, Abney DE, Szilagyi PG, Fiks AG. Clinician Prompts for Human Papillomavirus Vaccination: A Cluster Randomized Trial. Acad Pediatr 2024; 24:579-586. [PMID: 37925070 PMCID: PMC11056302 DOI: 10.1016/j.acap.2023.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/24/2023] [Accepted: 10/27/2023] [Indexed: 11/06/2023]
Abstract
OBJECTIVE We assessed the impact of an online intervention using clinician prompts for human papillomavirus (HPV) vaccination with a cluster randomized controlled trial. METHODS The randomized trial occurred July 2021-January 2022 in 48 primary care pediatric practices (24 intervention, 24 control) across the US. We trained clinicians via two online learning modules, plus weekly ''quick tips'' delivered via text or email. The training taught practices to implement a staff prompt to the clinician (e.g., printed reminders placed on the keyboard) plus electronic health record (EHR) prompts (if not already done) at well and acute/chronic visits for initial and subsequent HPV vaccination. We assessed missed opportunities for HPV vaccination using logistic regression models accounting for clustering by practice on an intent to treat basis. Surveys assessed facilitators and barriers to using prompts. RESULTS During the 6-month intervention, missed opportunities for HPV vaccination increased (worsened) in both intervention and control groups. However, at well child care visits, missed opportunities for the initial HPV vaccine increased by 4.5 (95% CI: -9.0%, -0.1%) percentage points less in intervention versus control practices. Change in missed opportunities for subsequent doses at well child care and non-well child care visits did not differ between trial groups. An end-of trial survey found understaffing as a common challenge. CONCLUSIONS Clinician prompts reduced missed opportunities for HPV vaccination at well child care visits. Understaffing related to the COVID-19 pandemic may have led to worsening missed opportunities for both groups and likely impeded practices in fully implementing changes.
Collapse
Affiliation(s)
- Cynthia M Rand
- Department of Pediatrics (CM Rand), University of Rochester School of Medicine and Dentistry, Rochester, NY.
| | - Alisa J Stephens-Shields
- Department of Biostatistics (AJ Stephens-Shields, R Localio, C Hannan, and RW Grundmeier), Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa
| | - Mary K Kelly
- Clinical Futures (MK Kelly and AG Fiks), Children's Hospital of Philadelphia, Philadelphia, Pa
| | - Russell Localio
- Department of Biostatistics (AJ Stephens-Shields, R Localio, C Hannan, and RW Grundmeier), Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa
| | - Chloe Hannan
- Department of Biostatistics (AJ Stephens-Shields, R Localio, C Hannan, and RW Grundmeier), Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa
| | - Robert W Grundmeier
- Department of Biostatistics (AJ Stephens-Shields, R Localio, C Hannan, and RW Grundmeier), Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa; Department of Biomedical and Health Informatics (RW Grundmeier and AG Fiks), Children's Hospital of Philadelphia, Philadelphia, Pa
| | | | - Jennifer Steffes
- Pediatric Research in Office Settings (J Steffes, K Davis, G McFarland, DE Abney, and AG Fiks), American Academy of Pediatrics, Itasca, Ill; Primary Care Research (J Steffes and K Davis), American Academy of Pediatrics, Itasca, Ill
| | - Kristin Davis
- Pediatric Research in Office Settings (J Steffes, K Davis, G McFarland, DE Abney, and AG Fiks), American Academy of Pediatrics, Itasca, Ill; Primary Care Research (J Steffes and K Davis), American Academy of Pediatrics, Itasca, Ill
| | - Christina Albertin
- Department of Pediatrics (C Albertin), University of California at Los Angeles, Mattel Children's Hospital, Los Angeles, Calif
| | - Sharon G Humiston
- Department of Pediatrics, Mattel Children's Hospital, UCLA, Los Angeles, CA, USA
| | - Greta McFarland
- Pediatric Research in Office Settings (J Steffes, K Davis, G McFarland, DE Abney, and AG Fiks), American Academy of Pediatrics, Itasca, Ill
| | - Dianna E Abney
- Pediatric Research in Office Settings (J Steffes, K Davis, G McFarland, DE Abney, and AG Fiks), American Academy of Pediatrics, Itasca, Ill
| | - Peter G Szilagyi
- Department of Pediatrics, Mattel Children's Hospital, UCLA, Los Angeles, CA, USA
| | - Alexander G Fiks
- Clinical Futures (MK Kelly and AG Fiks), Children's Hospital of Philadelphia, Philadelphia, Pa; Department of Biomedical and Health Informatics (RW Grundmeier and AG Fiks), Children's Hospital of Philadelphia, Philadelphia, Pa; Pediatric Research in Office Settings (J Steffes, K Davis, G McFarland, DE Abney, and AG Fiks), American Academy of Pediatrics, Itasca, Ill
| |
Collapse
|
4
|
Klassen AC, Lee G, Chiang S, Murray R, Guan M, Lo WJ, Hill L, Leader AE, Manganello J, Massey PM. Did the COVID-19 experience change U.S. parents' attitudes towards HPV vaccination? Results from a national survey. Vaccine 2024; 42:1704-1713. [PMID: 38355317 DOI: 10.1016/j.vaccine.2024.01.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 01/17/2024] [Accepted: 01/31/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND In the U.S., uptake of the HPV vaccine remains below coverage goals. There is concern that negative reactions to emergency initiatives during the COVID-19 pandemic, including vaccination, may have increased some parents' hesitancy towards all vaccines, including HPV. Understanding how different parent populations view routine vaccination post-pandemic is key to strategic efforts to maintaining and increasing uptake of HPV vaccine. METHODS In early 2022, we recruited an online panel of English-speaking U.S. parents and caregivers, who used the social media platform Twitter and had HPV vaccine-eligible but unvaccinated children age 9-14 years. Respondents completed a 20-minute survey measuring knowledge, attitudes and intentions regarding HPV vaccination for their child, as well as background socio-demographics and health information-seeking practices. Questions regarding experiences during the COVID-19 pandemic included changes in access to preventive care, and perceptions of whether pandemic experiences had positively or negatively affected their attitudes about routine vaccination, with open text capturing reasons for this change. RESULTS Among 557 respondents, 81 % were definitely or likely to vaccinate their child against HPV, with 12 % being uncertain, and 7 % unlikely to vaccinate. Regarding routine vaccination, most (70 %) felt their attitudes had not changed, while 26 % felt more positively, and only 4 % felt more negatively. Reasons for positive attitude change included increased appreciation for vaccines overall, and motivation to proactively seek preventive care for their child. Negative attitude changes stemmed from distrust of COVID-19 public health efforts including vaccine development, and disillusionment with vaccines' ability to prevent disease. In multivariable models, intention to vaccinate was greater among parents reporting greater education, Democratic affiliation, greater religiosity, and urban residence. Negative attitude change due to the pandemic independently predicted reduced HPV vaccination intention, while positive attitude change predicted positive intention. CONCLUSIONS Post-pandemic, most U.S. parents remain committed to vaccinating their children against HPV. However, addressing residual COVID-19 concerns could improve uptake among vaccine-hesitant parents.
Collapse
Affiliation(s)
- Ann C Klassen
- Drexel University Dornsife School of Public Health, Philadelphia, PA, United States.
| | - Giyoung Lee
- Drexel University Dornsife School of Public Health, Philadelphia, PA, United States
| | - Shawn Chiang
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX, United States
| | - Regan Murray
- Department of Counseling, Leadership, and Research Methods, University of Arkansas, Fayetteville, AR, United States
| | - Mengfei Guan
- Department of Communication, University of Oklahoma, Norman, OK, United States
| | - Wen-Juo Lo
- Department of Counseling, Leadership, and Research Methods, University of Arkansas, Fayetteville, AR, United States
| | - Larry Hill
- Department of Counseling, Leadership, and Research Methods, University of Arkansas, Fayetteville, AR, United States
| | - Amy E Leader
- Division of Population Science, Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, United States
| | - Jennifer Manganello
- Department of Health Policy, Management and Behavior, School of Public Health, University at Albany, State University of New York (SUNY), Albany, NY, United States
| | - Philip M Massey
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA, United States
| |
Collapse
|
5
|
Knijff M, van Lier A, Boer M, de Vries M, Hament JM, de Melker HE. Parental intention, attitudes, beliefs, trust and deliberation towards childhood vaccination in the Netherlands in 2022: Indications of change compared to 2013. Vaccine 2024; 42:801-811. [PMID: 38216441 DOI: 10.1016/j.vaccine.2023.12.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 12/21/2023] [Accepted: 12/27/2023] [Indexed: 01/14/2024]
Abstract
BACKGROUND Vaccine uptake within the Dutch National Immunisation Programme (NIP) has slightly declined since the COVID-19 pandemic. We studied psychosocial factors of vaccine uptake, namely parental intention, attitudes, beliefs, trust and deliberation (i.e., self-evidence), before (2013) and two years into the pandemic (2022). METHODS In 2022 and 2013, parents with a young child (aged < 3.5 years) participated in online surveys on vaccination (n = 1000 and 800, (estimated) response = 12.2 % and 37.2 %, respectively). Psychosocial factors were measured on 7-point Likert scales. Multivariate logistic regression analysis was used to study differences between parents in 2022 and 2013 in 'negative' scores (≤2) of psychosocial factors. RESULTS In both 2022 and 2013, most parents with a young child expressed positive intention (2022 = 83.1 %, 2013 = 87.0 %), attitudes (3 items: 2022 = 66.7 %-70.9 %, 2013 = 62.1 %-69.8 %) and trust (2022 = 51.8 %, 2013 = 52.0 %) towards the NIP and considered vaccinating their child as self-evident (2022 = 57.2 %, 2013 = 67.3 %). Compared to parents in 2013, parents in 2022 had significantly higher odds of reporting negative attitudes towards vaccination (3 items combined: OR = 2.84, 95 % CI = 1.09, 7.37), believing that vaccinations offer insufficient protection (OR = 4.89, 95 % CI = 3.19, 7.51), that the NIP is not beneficial for the protection of their child's health (OR = 2.23, 95 % CI = 1.15, 4.35), that vaccinating their child does not necessarily protect the health of other children (OR = 2.24, 95 % CI = 1.16, 4.33) or adults (OR = 2.22, 95 % CI = 1.32, 3.75) and that vaccinations could cause severe side effects (OR = 2.20, 95 % CI = 1.35, 3.58), preferring natural infection over vaccination (OR = 3.18, 95 % CI = 2.24, 4.51) and reporting low trust towards the NIP (OR = 1.73, 95 % CI = 1.08, 2.79). CONCLUSIONS Although most parents had positive intention, attitudes and trust towards vaccination and perceived vaccinating their child as self-evident, proportions of parents with negative scores were slightly larger in 2022 compared to 2013. Monitoring these determinants of vaccine uptake and developing appropriate interventions could contribute to sustaining high vaccine uptake.
Collapse
Affiliation(s)
- Marthe Knijff
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, the Netherlands.
| | - Alies van Lier
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, the Netherlands
| | - Maartje Boer
- Statistics, Data Science, and Modelling, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, the Netherlands
| | - Marion de Vries
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, the Netherlands
| | - Jeanne-Marie Hament
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, the Netherlands
| | - Hester E de Melker
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, the Netherlands
| |
Collapse
|
6
|
Higgins DM, Moss A, Blackwell S, O'Leary ST. The COVID-19 Pandemic and Parental Attitudes Toward Routine Childhood Vaccines. Pediatrics 2023; 152:e2023062927. [PMID: 37867454 DOI: 10.1542/peds.2023-062927] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/23/2023] [Indexed: 10/24/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The coronavirus disease 2019 (COVID-19) pandemic may have impacted parental attitudes toward childhood vaccines. However, few data sources followed attitudes before and after onset of the pandemic. We used data from a parental survey to describe the effect of the pandemic on parental attitudes toward childhood vaccines. METHODS Data were analyzed from the Health eMoms survey which randomly sampled birthing parents in Colorado from 2018 to 2021 on several health topics including vaccine hesitancy. Population weighted multivariable regression was used to measure the association between overall vaccine hesitancy and 5 individual hesitancy questions and different COVID-19 pandemic periods: prepandemic (April 2018-February 2020); pandemic prevaccine (April 2020-December 2020); and pandemic postvaccine (January 2021-August 2021), adjusting for demographic factors. RESULTS Overall, 20.4% (726/3553) of respondents were vaccine hesitant. Vaccine hesitancy during pandemic time periods was not different from the prepandemic period (prevaccine adjusted odds ratio [aOR] = 0.82, 95% confidence interval [CI] = 0.65-1.04; postvaccine aOR = 1.07, 95% CI = 0.85-1.34). In analyses of individual hesitancy questions, parents were more likely to be unsure about trusting vaccine information in the pandemic postvaccine time period compared with the prepandemic period (aOR = 2.14; 95% CI = 1.55-2.96), and less likely to be unsure about their hesitancy toward childhood vaccines (aOR = 0.48; 95% CI = 0.27-0.84). CONCLUSIONS The COVID-19 pandemic was not associated with changes in parental vaccine hesitancy overall, although there were changes in trust about vaccine information and a polarization of vaccination attitudes.
Collapse
Affiliation(s)
- David M Higgins
- Adult and Child Center for Outcomes Research and Delivery Science (ACCORDS), University of Colorado/Children's Hospital Colorado, Aurora, Colorado
| | - Angela Moss
- Adult and Child Center for Outcomes Research and Delivery Science (ACCORDS), University of Colorado/Children's Hospital Colorado, Aurora, Colorado
| | - Sarah Blackwell
- Colorado Department of Public Health and Environment, Denver, Colorado
| | - Sean T O'Leary
- Adult and Child Center for Outcomes Research and Delivery Science (ACCORDS), University of Colorado/Children's Hospital Colorado, Aurora, Colorado
| |
Collapse
|
7
|
Zimmermann C, Jusufoska M, Tolic J, Abreu de Azevedo M, Tarr PE, Deml MJ. Pharmacists' approaches to vaccination consultations in Switzerland: a qualitative study comparing the roles of complementary and alternative medicine (CAM) and biomedicine. BMJ Open 2023; 13:e074883. [PMID: 37696631 PMCID: PMC10496653 DOI: 10.1136/bmjopen-2023-074883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 08/23/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Many community pharmacies in Switzerland provide complementary and alternative medicine (CAM) approaches in addition to providing biomedical services, and a few pharmacies specialise in CAM. A common perception is that CAM providers are sceptical towards, or opposed to, vaccination. OBJECTIVES Key objectives of this study are to examine the potential roles of biomedically oriented and CAM-specialised pharmacists regarding vaccine counselling and to better understand the association between vaccine hesitancy and CAM. DESIGN We conducted semistructured, qualitative interviews. Transcripts were coded and analysed using thematic analysis. Interview questions were related to: type of pharmaceutical care practised, views on CAM and biomedicine, perspectives on vaccination, descriptions of vaccination consultations in community pharmacies and views on vaccination rates. SETTING Qualitative interviews in three language regions of Switzerland (German, French and Italian). PARTICIPANTS We interviewed 18 pharmacists (N=11 biomedically oriented, N=7 CAM specialised). RESULTS Pharmacist participants expressed generally positive attitudes towards vaccination. Biomedically oriented pharmacists mainly advised customers to follow official vaccination recommendations but rarely counselled vaccine-hesitant customers. CAM-specialised pharmacists were not as enthusiastic advocates of the Swiss vaccination recommendations as the biomedically oriented pharmacists we interviewed. Rather, they considered that each customer should receive individualised, nuanced vaccination advice so that customers can reach their own decisions. CAM-specialised pharmacists described how mothers in particular preferred getting a second opinion when they felt insufficiently advised by biomedically oriented paediatricians. CONCLUSIONS Vaccination counselling in community pharmacies represents an additional option to customers who have unmet vaccination consultation needs and who seek reassurance from healthcare professionals (HCPs) other than physicians. By providing individualised vaccination counselling to vaccine-hesitant customers, CAM-specialised pharmacists are likely meeting specific needs of vaccine-hesitant customers. As such, research and implementation efforts should more systematically involve pharmacists as important actors in vaccination provision. CAM-specialised pharmacists particularly should not be neglected as they are important HCPs who counsel vaccine-hesitant customers.
Collapse
Affiliation(s)
- Clara Zimmermann
- University Department of Medicine, Kantonsspital Baselland, Bruderholz, Switzerland
- University of Basel, Basel, Switzerland
| | - Meliha Jusufoska
- University of Basel, Basel, Switzerland
- Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Josipa Tolic
- University of Basel, Basel, Switzerland
- Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Marta Abreu de Azevedo
- University of Basel, Basel, Switzerland
- Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | | | - Michael J Deml
- Institute of Sociological Research, Department of Sociology, University of Geneva, Geneva, Switzerland
| |
Collapse
|
8
|
Kim S, Zhou K, Parker S, Kline KN, Montealegre JR, McGee LU. Perceived Barriers and Use of Evidence-Based Practices for Adolescent HPV Vaccination among East Texas Providers. Vaccines (Basel) 2023; 11:vaccines11040728. [PMID: 37112640 PMCID: PMC10146224 DOI: 10.3390/vaccines11040728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 03/17/2023] [Accepted: 03/21/2023] [Indexed: 03/29/2023] Open
Abstract
Adolescents living in rural areas are less likely to be up to date on the human papillomavirus (HPV) vaccine, which can prevent cervical cancer. We administered a telephone survey to 27 clinics in rural East Texas to assess perceived barriers to HPV vaccination and current use of evidence-based interventions to promote HPV vaccination. Perceived barriers were assessed using a 5-point Likert scale and clinical implementation of evidence-based practices was determined. Findings are reported using descriptive statistics. The most commonly reported barriers were missed vaccination opportunities due to the pandemic (66.7%), followed by vaccine hesitancy due to the pandemic (44.4%) and due to the HPV vaccine specifically (33.3%). Fewer than a third of clinics reported using the evidence-based strategies of use of a “refusal to vaccinate” form (29.6%), having an identified HPV vaccine champion (29.6%), and recommending the HPV vaccine at age 9 (22.2%). While many clinics surveyed currently implement evidence-based practices to promote HPV vaccination, there is a need and desire for additional HPV vaccination interventions in East Texas clinics.
Collapse
Affiliation(s)
- Sarah Kim
- Department of Medical Education, Baylor College of Medicine, Houston, TX 77030, USA
| | - Kelvin Zhou
- Department of Medical Education, Baylor College of Medicine, Houston, TX 77030, USA
| | - Susan Parker
- Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX 77030, USA
| | - Kimberly N. Kline
- Department of Communication, The University of Texas at San Antonio, San Antonio, TX 78249, USA
| | - Jane R. Montealegre
- Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX 77030, USA
- Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA
| | - Lindy U. McGee
- Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX 77030, USA
- Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA
- Correspondence: ; Tel.: +1-713-873-6356
| |
Collapse
|